Epidemiology, risk factors, species distribution, andantifungal susceptibility of candidemia among hospitalized patients withCOVID-۱۹

Background and Aim : The pandemic of COVID-۱۹ has caused a worldwide health crisis.Candidemia is a potentially lethal condition that has not yet been enough discussed in patients withCOVID‐ ۱۹. The current study aimed to investigate the prevalence of candidemia among IranianCOVID‐ ۱۹ patients and characterize its causative agents and the antifungal susceptibility pattern.Methods : The present cross-sectional survey was carried out from March ۲۰۲۰ to March ۲۰۲۱ atImam Khomeini Hospital, Tehran, Iran. Blood specimens were obtained from patients withconfirmed coronavirus infection who also had criteria for candidemia and were examined for anyCandida species by conventional and molecular techniques. Susceptibility of isolates toamphotericin B, voriconazole, itraconazole, fluconazole, caspofungin, and ۵-flucytosine wastested using the CLSI broth dilution technique.Results : In total, ۱۵۳ patients with COVID-۱۹ were included and candidemia was confirmed in۱۲ (۷.۸ %) of them. The majority of patients were ≥ ۵۰ years of age (n=۹) and female (n=۸).Moreover, ۶ out of the ۱۲ patients were diabetic. The presence of central venous catheters, broadspectrumantibiotic therapy, ICU admission, and mechanical ventilation was observed in allpatients. The C. albicans (n=۷, ۵۸.۳ %) and C. dubliniensis (n=۲, ۱۶.۷%) were the most commonisolated species. Amphotericin B and ۵-flucytosine were the most active drugs. Despite antifungaltreatment, ۴ out of ۱۲ patients (۳۳.۳ %) died.Conclusion : Due to the high mortality, the early diagnosis and proper treatment of candidemiaare essential requirements for optimal clinical outcomes in COVID-۱۹ patients.

کلیدواژه ها:

Candidemia ، C. albicans ، C. dubliniensis ، COVID-۱۹ ، Iran